New Natural Treatment For Bipolar Disorder In Children

Nearly every child occasionally exhibits "unusual" behavior. And nearly every teen sometimes exhibits extreme "moodiness." A certain amount of emotional distress is normal for growing up. However, some children and teens experience predictable, although not necessarily manageable, patterns of emotional highs and lows that are diagnosed as bipolar disorder.

Drugs designed to relieve ups can cause painfully dark and depressing downs and drugs designed to relieve downs can cause uncontrollable ups. However, a combination of two well-known, readily available, inexpensive, and generally side effect free supplements may relieve symptoms in children.

Dr. Joseph Biederman, a doctor of medicine, director of the Pediatric Psychopharmacology Unit at Massachusetts General Hospital in Boston, recently presented finding of a study of omega-3 essential fatty acids from fish oil and a plant-based supplement called inositol in the treatment of bipolar disorder in patients aged 6 to 12 at the American Society of Clinical Psychopharmacology (ASCP) 2014 Annual Meeting. 

"The effects that we saw with these products, particularly the combination of high EPA omega-3 fatty acids plus inositol, were comparable to the effects that we are accustomed to seeing with more toxic drugs. It was quite surprising and quite impressive," Dr. Biederman told reporters attending the meeting.

Biederman and his colleagues conducted a study with 24 children aged 6 to 12 years who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for bipolar spectrum disorder. All of the children were given two kinds of "pills" every day. Seven children were given 3000 mg of fish containing eicosapentaenoic acid and docosahexaenoic acid (EPA and DHA) every day and a placebo. Seven children were given 2000 mg of inositol and a placebo every day. Ten children were given both 3000 mg of fish oil and 2000 mg of inositol every day. Children who weighed less than 25 kilos (55 pounds) were given reduced doses.  The experiment was conducted for 12 weeks.

At the end of the three months of the study, children who were given both supplements scored the greatest improvements on the Young Mania Rating Scale, and on the  Hamilton Rating Scale for Depression. There were no serious side effects from the supplements, although some children experienced minor gastrointestinal problems (flatulence, loose stools, or fishy burps) when taking fish oil. 

See Also: Bipolar disorder

Dr. Biederman admitted that neither he nor other researchers really know how these supplements work in bipolar disorder, just that they do. These products have not been studied enough that doctors know which children with bipolar disorder benefit most from the treatment, or whether the children get any special benefits or experience any special problems when taking them long-term. However, the absence of toxicity of fish oil and inositol make them very attractive. And when used separately, both products have a long track record of efficacy in treating both the ups and the downs of bipolar disorder.

What Doctors Know About Supplements For Bipolar Disorder

It is important to understand that nutritional supplements do not "cure" bipolar disorder. They just help manage symptoms. That being said, there is more than just the previously mentioned single study in support of the use of omega-3 essential fatty acids and inositol in supportive therapy for the condition.

At least 118 scientific studies have considered the use of fish oil, a common source of omega-3 essential fatty acids, as a treatment for bipolar disorder. A general trend of the findings of these studies is that as a component of the hormones every cell in the body uses to make hormones that regulate and limit formulation, omega-3 essential fatty acids reduce the effects of inflammation in the brain so that it is more responsive to the neurotransmitters dopamine, serotonin, and norepinephrine.  The docosahexaenoic acid (DHA) component of fish oil also serves as a building block for nerve tissue in the brain.

 Inositol seems to exert its influence on the brain by limiting the bursts of energy made in the mitochondria in brain cells during manic episodes. Scientists have recently discovered that inositol activates the same genes as lithium, and has some of the same effects on energy production in brain cells as lithium. There have been at least 291 published scientific studies of various aspects of the effects of inositol on the brain in bipolar disorder.

Both products are inexpensive, almost free of side effects, and at least partially effective in controlling the symptoms of bipolar disorder. There isn't any evidence that people who take them for a day, a week, a month, or a year will be cured of their bipolar disorder. The washout period, after which the supplements cease to have any effect after they are no longer taken, is probably just a few days.

Who is most likely to benefit from fish oil and/or inositol for bipolar disorder? People who don't get good results with conventional medications are the logical recipients for nutritional supplements. They are worth a try. Scientists are only beginning to understand how genetics relates to the efficacy of medication for bipolar disorder; presumably some people with bipolar disorder would get greater benefits from fish oil and inositol than others, but doctors don't know who benefits most.

See Also: Inside Bipolar Mind

And is it safe to take fish oil and inositol with conventional psychotropic medications for bipolar disorder? Laboratory studies with mice suggest that inositol does not reverse the effects of lithium treatment. There are no reports of drug interactions or reduced drug effectiveness when using the supplements. The benefits of inositol are greater when users avoid giving in to the "munchies," since it works in part by helping brain cells recycle malformed proteins during fasting--so avoid nighttime snacks and heavy meals when taking these products.